MEDICARE: RANDI L JONES PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA04957	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00954314	OTHER	TX	RAILROAD MEDICARE
2	P00453355	OTHER	TX	RAILROAD MEDICARE
3	714778	OTHER	TX	MEDICARE PART B
7	TXB120921	OTHER	TX	MEDICARE PART B - EFFECT 02/01/2011

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	8Y1403	OTHER	TX	BC/BS TEXAS
5	1780745679	OTHER	TX	NPI
6	835N04	OTHER	TX	BCBS TX 02/01/2011

General Provider Information

NPI Number	:	1780745679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI L JONES PA-C

Provider Business Mailing Address
First Line	:	3200 COLORADO BLVD STE 101
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-6875
Country	:	US
Telephone Number	:	940-331-7222
Fax Number	:	940-514-2224

Provider Business Practice Location Address
First Line	:	3200 COLORADO BLVD STE 101
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-6875
Country	:	US
Telephone Number	:	940-331-7222
Fax Number	:	940-514-2224

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	05/15/2026

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Directions to “ RANDI L JONES PA-C” Practice Location

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